Non-Surgical Knee Therapy

Non-Surgical Knee Therapy

The knee is the body's biggest joint. Daily tasks necessitate near-normal knee function. The knee joint is formed by the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and the kneecap (patella). Stability is provided by the vast ligaments that link to the femur and tibia, while strength is provided by the lengthy thigh muscles.The articular surfaces where these three bones come into contact with each other are covered with cartilage. This cartilage acts as a cushion. This allows the bones to move easily over each other. Damage to this cartilage over time and the formation of calcifications can lead to knee pain that can affect daily life. Chronic knee pain can occur for many reasons and it is very important to treat the disease before it progresses.

Causes of chronic knee pain
Osteoarthritis is the most common cause of chronic knee pain. Osteoarthritis, rheumatoid arthritis and traumatic arthritis are the types of arthritis that cause chronic knee pain.

Osteoarthritis usually occurs after the age of 50. Genetic predisposition is one of the most important causes. The cartilage that acts as a cushion for the bones softens and tears. The bones rub against each other, causing chronic knee pain and limitation of movement.

In rheumatoid arthritis, the joint membrane thickens and this causes inflammation. Excessive amounts of joint fluid fill the joint. Chronic inflammation causes cartilage damage and cartilage loss occurs. This causes pain and loss of movement in the joints.

Post-traumatic calcification, which we call traumatic arthritis, occurs after serious knee trauma. Knee fractures and ligament injuries lead to cartilage damage over time. This can lead to chronic knee pain and loss of function. In such cases, knee replacement is an important treatment option.

How can we get rid of knee pain without surgery?
There are many non-surgical methods and treatment options for knee pain. These are

Weight loss
Exercise and walking
Pain medication treatments
Spas and hot treatments
Glucosamine and chondroitin preparations
Intra-articular injections
Physical therapy and rehabilitation
Lose weight

Excess weight is a burden on the knee. For this reason, the patient should reach his/her ideal weight and lose the excess weight under the control of a dietician. In this way, the load on the knee decreases and the progression of the disease slows down. The effectiveness of the treatment also increases.

Exercise and walking

Pain is the most significant requirement for exercise. There is no harm in walking every day if you are not in pain. However, if you are in pain, you should avoid straining your knees. Indoor bicycles are good exercise equipment if you are too tired to walk. You should also avoid squatting and using stairs or slopes while exercising.

Non-Surgical Treatment Options for Knee Osteoarthritis
Pain medication

Painkillers are the first choice. Simple painkillers such as paracetamol and aspirin are effective as the first option. Rheumatism medications are a second option. Rheumatic drugs, which are very useful in the early stages of the disease, can have side effects on the stomach. Therefore, we do not recommend long-term use.  

Spa and heat treatments

Hot springs and hot treatments can be beneficial for patients without hypertension and cardiovascular disease. However, it is important to seek medical advice and approval beforehand.

Glucosamine and chondroitin preparations

Glucosamine and chondroitin sulfate are the most often utilized oral drugs in the treatment of gonarthrosis nowadays. These two substances are structures in normal articular cartilage that are required for cartilage survival and have the function of preventing cartilage cell multiplication as well as the suppression of enzymes that contribute to cartilage cell loss. These compounds have no analgesic effects.However, some reduction in pain can be achieved thanks to the MSM substance added to the medication. The duration of their use is 6 months and they can be used again after a break for a while.

Intra-articular injections

Corticosteroids (cortisone) and hyaluronic acid, also called cartilage preservative, can be injected into the knee. Corticosteroids act both as painkillers and reduce inflammation. However, corticosteroids have a short duration of action. Therefore, they need to be used in repeated doses. For this reason, we do not recommend them in cases of gonarthrosis, especially in the early stages. We mostly use it in patients who are in advanced stages and do not want or cannot undergo surgery.

Hyaluronic acid is naturally present in the articular cartilage. It is an important substance for the lubrication of the knee joint fluid. It also protects cartilage cells. In gonarthrosis, hyaluronic acid deficiency occurs. Therefore, injecting hyaluronic acid into the knee is also an important treatment option.

Physical therapy and rehabilitation

Physical therapy can be very effective in the initial stages of arthritis. However, the effect decreases in progressive cases of arthritis. Despite this, we can say that every gonarthrosis patient needs physical therapy. It is especially effective in strengthening the muscles above the knee and hip muscles. Physical therapy also increases the success of a possible prosthesis surgery at an advanced age.

Arthroscopic knee surgery
Successful results can be obtained with arthroscopic knee surgery in mild to moderate arthritis.

How is it done?
A camera is inserted into the joint through a small hole and the image is transferred to the monitor. The operation is then performed with surgical instruments inserted into the joint through a small hole and monitored on the monitor.

Damaged cartilages and torn menisci are cleaned and repaired. However, there is no new cartilage formation here. Only the surfaces are smoothed. This aims to reduce friction, wear and pain.

Arthroscopic knee surgery is an easy technique. However, it is a procedure that should be done very gently. Because too much can cause excessive cartilage loss and more problems.

After surgery
Patients can be discharged after one day of hospitalization. There is no pain after surgery. The patient does not need to use crutches and can walk with a load directly on his/her leg, go up and down stairs. It is necessary to apply ice and rest for 3 days after the surgery. Patients can usually return to their daily work within 10-20 days.